The precarious practice of forensic psychiatric risk assessments

Nilsson, Thomas; Munthe, Christian; Gustavson, Christina; Forsman, Anders; Anckarsäter, Henrik

doi:10.1016/j.ijlp.2009.09.010

Cited by 26 publications

(25 citation statements)

References 25 publications

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“…The estimated risk of relapse in serious criminality is thus the dividing line between patients' sentences to treatment with and without a SCS. In practice, the nature of the index crime has been shown to play a major role in these risk assessments (Nilsson, Munthe, Gustavson, Forsman, & Anckarsäter, 2009), and therefore we were not surprised to find violent index crime one of the strongest risk factors for long hospital stay in this study. On the other hand, the fact that absconding was the only risk incident or adverse event significantly linked to longer hospital stay was surprising.…”

Section: Discussionmentioning

confidence: 50%

Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence

Andreasson

Nyman

Krona

et al. 2014

International Journal of Law and Psychiatry

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113

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This study describes the prevalence of adverse events and length of stay in forensic psychiatric patients with and without a restriction order. Detailed clinical and administrative information from medical records and written court decisions was gathered retrospectively from admission until discharge for a Swedish population-based, consecutive cohort of forensic psychiatric patients (n=125). The median length of stay for the whole cohort was 951 days, but patients with a restriction order stayed in hospital almost five times as long as patients without. Restriction orders were related to convictions for violent crime, but not for any other differences in demographic or clinical variables. The majority of the patients (60%) were involved in adverse events (violence, threats, substance abuse, or absconding) at some time during their treatment. Patients with restriction orders were overrepresented in violent and threat events. Previous contact with child and adolescence psychiatric services, current violent index crime, psychotic disorders, a history of substance, and absconding during treatment predicted longer length of stay. Being a parent, high current Global Assessment of Functioning scores, and mood disorders were all significantly related to earlier discharge. In a stepwise Cox regression analysis current violent index crime and absconding remained risk factors for a longer hospital stay, while a diagnosis of mood disorder was significantly related to a shorter length of stay.

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Section: Discussionmentioning

confidence: 50%

Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence

Andreasson

Nyman

Krona

et al. 2014

International Journal of Law and Psychiatry

Self Cite

113

View full text Add to dashboard Cite

show abstract

“…Further, it is challenging to ensure that an assessment does not result in discrepancies between how the forensic nursing staff perceive risk, and how the team or individual risk assessor scores the patient risk (Samuels et al, 2005). Besides, it is not uncommon that the risk assessor is also the caregiver of the patients, which could result in conscientious risk analysis (Nilsson et al, 2009). Finally, one of the most significant challenges of how well clinicians succeeded in implementing knowledge into practice, is whether or not they are guided by a visionary leadership and work in a care unit where participation and reflexive learning are encouraged (Harvey & Kitson, 2016).…”

Section: Challenges Related To Forensic Risk Assessmentmentioning

confidence: 99%

“…In violence-risk research, there is broad agreement that an absolute risk is impossible to establish (Sing, Fazel, Gueorguieva, & Buchanan, 2014) and, further, that a RA constantly needs updating (Nilsson, Munthe, Gustavson, Forsman, & Anckarsäter, 2009). …”

Section: Introductionmentioning

confidence: 99%

Violence Risk Assessment in Forensic Nurses’ Clinical Practice: A Qualitative Interview Study

Olsson

Kristiansen

2017

GJHS

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Background: The legislation of Swedish forensic psychiatric care states that the risk of further violence must be assessed before a patient is granted release from a forensic psychiatric hospital. The aim of the study was to describe the experiences of forensic nurses with in-patient risk assessment processes, and their implication for daily clinical forensic praxis.Method: Semi-structured interviews with staff who were involved in the patients risk assessment process. The interview texts were analyzed using qualitative latent content analysis. Discussion:The forensic nursing staff has to deal with many contradictory realities. The description was about being able to balance between supporting their work with an EBP approach of risk assessment while trying to establish interpersonal relationships and to allow for positive meetings with the patient. The study indicated that staff used a multiple sources of knowledge in order to make credible and accurate risk assessments. Conclusions:If the risk assessment process are to be used in a legally secure manner, the staff must receive regular support from team leadership that can provide both guidance and training. Based on a holistic approach, the link between the instinct of staff and their work with structured risk assessment must be founded on routines and solid platforms.

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“…As such, the accuracy of prediction and control of high risk behaviour in specific offender groups has been discarded by the use of heterogeneous samples in conjunction with the homogeneity of the determinants being studied (Quinsey et al, 2006). In line with evidence based medicine (EBM), 'What Works' principles and best practice guidelines, there is a need for specific explanations for different types of offenders and for different types of offences (Andrews & Bonta, 2010;Bradford, Fedoroff & Gulati, 2013;De Vogel, Stam, Bouman, Ter Horst & Lancel, 2015;Heilbrun, 2009;Nilsson, Munthe, Gustavson, Forsman & Anckarsäter, 2009;Quinsey et al, 2006).…”

Section: Forensic Psychiatry; a Composed Settingmentioning

confidence: 99%

Methodological development of the Hoeven Outcome Monitor (HOM): A first step towards a more evidence based medicine in forensic mental health

Keune

Vogel

Marle

2016

International Journal of Law and Psychiatry

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The precarious practice of forensic psychiatric risk assessments

Cited by 26 publications

References 25 publications

Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence

Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence

Violence Risk Assessment in Forensic Nurses’ Clinical Practice: A Qualitative Interview Study

Methodological development of the Hoeven Outcome Monitor (HOM): A first step towards a more evidence based medicine in forensic mental health

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